Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Thursday, February 26, 2009

Medical Advice Is Just Wrong

Medical advise says to avoid sun, fats and red meat, but to drink lots of water, eat polyunsaturated vegetable oils and focus on the grain-rich bottom of the food pyramid. The medical advice is simply wrong and is not supported by the biomedical literature. A recent article in a major medical journal claims that about 90% of medical advice is not based on clinical research studies, but rather represents the opinions of experts who are supported by the health industry. Most research is conducted to support products. Unfortunately the advice that comes from medical societies is not healthy.

Here I will provide a few examples to illustrate that medical advice is frequently, if not usually, wrong about diet, nutrition, cause of disease, appropriate drug use and whether to spend a few unprotected moments basking in sunshine.

The Sun Is Not the Enemy, but Sun Blockers Can Increase Skin Cancer

Medicine is supposed to provide instructions on how to handle dangerous chemicals and procedures safely and to enhance health. Solar radiation is dangerous and will cause skin cancer if used inappropriately, but solar radiation is also needed to produce vitamin D in skin. The public response to the medical mandate to limit solar exposure to reduce radiation-based skin cancer resulted in increased use of solar-blocking lotions. Unfortunately, the result was that some people spent more time in the sun, assuming that avoiding sun burns meant that they were avoiding skin cancer. Unknowingly they had shifted their skin exposure down from doses sufficient to kill cells and cause inflammation, to levels sufficient to just cause solar mutagenesis -- the lower exposures were optimal for skin cancer production.

Spare the Sun and Spoil the Child

Babies and children are the most sensitive to solar radiation induced skin cancer and need protection from over exposure, but the public response to medical advice has been to avoid prudent exposure to the sun. Now kids in the U.S. are showing symptoms of rickets, a vitamin D deficiency disease common during early industrialization, in which air pollution, urban poverty and factory work limited solar exposure. Babies in strollers are completely covered. One frightening consequence of this over-reaction could be a resurgence of poor bone growth that in the 1920’s resulted in the development of the now-trendy Cesarean section procedure to accommodate women with malformed pelvises due to rickets.

Rickets Is Rampant

Ubiquitous vitamin D deficiencies due to inadequate sun exposure is compounded by inadequate sources of dietary vitamin D and inappropriate medical interventions. Most vitamin D deficiencies go unnoticed, because the typical symptoms of deficiency mimic other forms of inflammation. When serum levels of vitamin D are actually measured and found to be inadequate, supplements of 600-1000 iu/day of vitamin D3 are prescribed. Unfortunately, there is seldom followup testing and a recent study indicates that most treatment for vitamin D deficiencies is inadequate -- much higher doses, ca. 2-5000 iu/day are required to reach optimum levels. Most people are and remain vitamin D deficient.

Scourge of Scurvy

Vitamin C deficiencies are also a problem. Most people get enough vitamin C to avoid losing their teeth (vitamin C is needed for collagen production), but subclinical deficiencies still produce chronic inflammation. The major cellular anti-oxidant is glutathione, but vitamin C is another major defense against reactive oxygen species (ROS). An increase in ROS triggers oxygen stress and inflammation. Deficiency of vitamin C indicates that more vitamin C is being used up than is being replenished in the diet. Numerous metabolic disturbances associated with other deficiencies or infections can result in vitamin C depletion and chronic inflammation. Most people are vitamin C deficient.

Vegetable Oils Are the Problem, Not the Cure

Medical advice to avoid saturated fats in meats and shift to omega-6-rich vegetable oils is a major contributor to chronic inflammation and modern degenerative diseases. The original claimed association between saturated fat consumption and cardiovascular disease was tenuous, but produced a glacial shift in diet toward consumption of omega-6 fatty acids, e.g. corn and soy oils. The medical dependence on measurements and treatments of LDL, has outweighed the actual data in the biomedical literature -- LDL levels are not important in cardiovascular disease. Drugs that lower LDL, serum cholesterol, are only effective in reducing heart disease, if they lower LDL by lowering inflammation. The risk factor is the inflammation, not the LDL level. Agricultural practices that use grain over grass further reduce the omega-3 fatty acid content of meat and increase the inflammatory omega-6 fatty acid level.

Statins Are a Problem, Not the Cure

Statins are broad spectrum disrupters of the function of many different enzymes and proteins. They were originally isolated from fungi based on their ability to poison bacteria, i.e. they are antibiotics. They disrupt fat metabolism and thereby lower LDL levels, but they also cause many undesirable and potentially dangerous side-effects. One of these actions is to block inflammation triggered by activation of the inflammation transcription factor, NFkB. By blocking NFkB activation, some statins lower inflammation and thereby decrease cardiovascular disease. This activity is similar to aspirin, which acts on COX-2 as well as directly on NFkB. Both statins and aspirin (NSAIDs) have multiple activities on numerous areas of cellular metabolism. The activities of both include reduction in inflammation, but they also produce other undesirable side effects. Chronic inflammation is better treated by diet, exercise and traditional herbs and spices, rather than more dangerous statins.

Water Is Miraculous, but just Satisfy Your Thirst

If you are thirsty drink tap water. There is no improvement in health by drinking some extra amount of water each day. Drinking water in plastic bottles from magical sources provides no improvement in health. Much of the “spring water” with designer labels is only locally bottled tap water. The plastic bottles are an ecological disaster and the “purified” water in the bottles is contaminated with compounds leaching from the bottles. If you want a constant source of water, bottle your own tap water. If you want to avoid the minor contaminants added to avoid bacterial contamination of municipal water supplies, use a simple point-of-use filter.

Starch Is the Problem

Starch is rapidly converted into blood glucose and that spike in blood sugar causes major problems. The foundation of the old food pyramid, grains, is no different than table sugar in being hyperglycemic, i.e. rapidly raising blood sugar. A large muscle mass and high physical activity can minimize the rise in blood sugar, by using up the sugar for muscle energy as it enters the blood. Unfortunately, most people do not have enough muscle and are not physically active enough to be protected from the starch and sugars in their diets. The result is chronic inflammation in the form of metabolic syndrome and degenerative diseases, e.g. diabetes, allergies, depression, acne, infertility, cardiovascular disease, autoimmune diseases and cancers.

One slice of white bread with a meal may be too much starch for some people. The maximum for most people is: one half of a ripe banana or one half cup of a starchy entree such as pasta, potato, rice, or one of the two buns on a burger. The starch needs to be spread over several meals. Eating too much starch with a meal produces intense hunger, as the blood sugar rapidly rises, triggers insulin release and a subsequent crash in blood sugar. Don’t believe any of the diets that recommend starches to replace fats. Many “lite” diet foods are more unhealthy than the higher fat originals that they replace. Replacing saturated fats with saturated starch is dangerous. The temporary high blood sugar level produces the increased health risks routinely associated with diabetes.

Insufficient Food Is the Problem -- Insufficient Minerals

It takes only 2-3000 Calories per day to energize most people. That means that most people can eat their day’s worth of calories with the sandwich plate at a fast food restaurant. That meal will provide an overdose of starch and sugar, but will be deficient in vitamins and minerals. A major dilemma is that it takes so little food to provide adequate energy for a low activity lifestyle, that the choice must be made between obesity and vitamin/mineral deficiencies. Eating just enough to satisfy energy needs results in deficiencies, but eating more to avoid vitamin/mineral deficiencies, results in obesity. The only solutions are to eat supplements to supply needed vitamins, minerals, antioxidants, etc. or increase physical activity and body muscle mass, so that more can be eaten without producing obesity. For most people the solution is a combination of increased physical activity and supplements. That combination is also found to reduce inflammation and the associated risk of degenerative diseases.

It’s the Stupid Diet

The obsession of medicine with drugs and invasive procedures provides additional health risks for patients. Many researchers complain in the biomedical literature that there is insufficient focus on the cause of disease and too much emphasis on the study of the impact of specific drugs on disease symptoms. The result is that in most cases the symptoms are treated and the disease becomes chronic. Of course this also means that the patient is a permanent consumer of health care.

The foundation of all healthcare should be to improve the lifestyle of the patient. Diseases don’t just happen. The biggest contributions of immediate family to disease of an individual are not defective genes, but rather defective diet and lifestyle habits. Our healthcare system is too no fault. People are sick because there is something wrong with how they live. They eat too much or they eat the wrong foods. They don’t get enough exercise to develop a healthy muscle system to support their joints. Most importantly, bad diet and lifestyle choices produce chronic inflammation. Drugs can reduce chronic inflammation, but will also produce additional side effects that will also require interventions. It makes more sense to attack the original causes of inflammation.

Every treatment program should address the pervasive contribution of chronic inflammation by including a diet and lifestyle inventory and an assessment of the cause of the disease that is being treated. An appropriate anti-inflammatory diet and a path toward a more active lifestyle should be the foundation of every treatment plan.

7 comments:

Nigel Kinbrum BSc(Hons)Eng said...

A hospital pharmacist told me yesterday that, because mum is being injected daily with Tinzaparin (a Low Molecular Weight Heparin) to prevent DVT, I can't give her Glucosamine Sulphate, Vitamin D3, Turmeric, Goldenseal or Vitamin K2. I queried the Vitamin K2 as LMWHs shouldn't be affected by Vitamin K but she insisted that they were and she was a pharmacist so she should know. I didn't want to antagonise her so I didn't argue.

However, LMWHs bind to antithrombin which then inactivates thrombin and factor Xa. As factor Xa is produced from factor X and factor X is produced in the liver with the help of Vitamin K, how on earth can taking Vitamin K make any difference to the inactivating effect of antithrombin?

Is her Medical Advice wrong?

Dr. Art Ayers said...

Heparin is the name given to a whole group of sulfated fragments produced when heparan sulfate polysaccharides are chopped up by an enzyme before being secreted by mast cells. Heparin provides the negative charge that neutralizes the positive charge of histamine that is simultaneously secreted. Tinzaparin is just a subset of the whole heparin mixture that can be extracted from Chinese hog intestines.
Don't think that Tinzaparin only acts on antithrombin, since it also binds to growth factors and their receptors, and a hundred other proteins involved in clotting, complement action, etc. Tinzaparin will change most of the extracellular interactions of the cells it encounters. It should also calm down inflamed tissues and repair heparin-depleted kidneys (lose of extracellular heparan leads to protein lose from blood to urine.) It should be generally good for cells, until it saturates on the circulatory surfaces and starts to saturate blood proteins. At that point it starts to influence clotting. A tendency to clot is a symptom of chronic inflammation. Your mum was probably already resistant to DVT, because of your dietary interventions, but immobility and other treatments may favor inflammation. It would have been interesting to know her clotting time the week before she went into the hospital and see how much Tinzaparin it would take to produce a given clotting time before and after she was admitted.
They probably don't want to let her have supplements, because they will change her sensitivity to the Tinzaparin by altering her inflammation level.
Heparin is an integral part of all of these interactions and it is uniformly ignored. Remember, it is a structural component of Alzheimer's amyloid plaque, as well as the plaque that forms in blood vessels. It is everywhere and is rapidly recycled in and out of cells.
Good luck with your mum.

Nigel Kinbrum BSc(Hons)Eng said...

Thank you for that. Hospital staff are too busy to explain things. Mum will soon be discharged from hospital into temporary residential care for rehabilitation to restore her mobility.

Frederick said...

Hello Dr.! "...Medical advice to avoid saturated fats in meats and shift to omega-6-rich vegetable oils is a major contributor to chronic inflammation and modern degenerative diseases..."
- Makes a lot of sense to me.

I believe that saturated fats play an important role in achieving and maintaining optimal health. It's so important that the body itself manufactures saturated fat, not leaving it to chance.

Also, few people know that there is more than one type of saturated fat?

Coconut oil is 92% saturated but predominantly medium chain fatty acids (MCFA). Almost all other fats/oils (saturated or unsaturated, plant- or animal-based) are mostly, if not entirely, long chain fatty acids (LCFA).

MCFAs are quickly digested by your body. MCFA-rich coconut oil goes straight to your liver to power metabolism, which simply can't be said of LCFA-rich oils. MCFAs are so different from LCFAs. Their absorption, transport, metabolism and uses are completely different. Just my two cents.

Cheers,
CoconutOilGuy
www.coconut-oil-central.com
Your Drugstore in a Bottle

Anna said...

Greetings from San Diego! Just found your blog. So much to agree on...

M said...

What are your views on resistant starch? From what I've read, it appear that as long as you eat starchy foods in the raw (those that are edible in that state, in any case) their starch is actually the same as a fibre, with all the benefits that provides. Meaning that in theory as long as you eat a potato raw it won't have that high glycemic effect and may be quite beneficial.

I'm also curious about the effect that freezing has on food. Everyone says freezing (and then thawing) in no way alters the nutritonal content of food, but the maceration caused to the cells by ice crystals has to cause some damage, no? Is eating, say, a thawed potato the same as eating a fresh one?

Thank you for your blog, I find it very informative. :)

wpbtola said...

I love this informative site (and am impressed that you make it readable even for the lay person)... Everything you suggest makes sense with one exception... to drink regular tap water. I understand that decent filters will take care of most pathogens, but they will not take care of the fluoride. Considering all the recent studies (past 20 yrs really) concerning the dangers of this substance in the human body (particularly because tap water sources don't use pharm. grade fluoride), shouldn't it be a concern?